Matthew Nicholas Kunkelman, PA is a medicare enrolled "Physician Assistant" in Holly Hill, South Carolina. His current practice location is
187 Bunch Ford Rd, Holly Hill, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(803) 496-3312.
Matthew Nicholas Kunkelman is licensed to practice in South Carolina (license number 2209) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1629473012.
Provider's Profile
| Full Name | Matthew Nicholas Kunkelman |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 187 Bunch Ford Rd, Holly Hill, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1629473012
- Provider Enumeration Date: 10/28/2014
- Last Update Date: 01/06/2017
Medicare PECOS Information:
- PECOS PAC ID: 2163737511
- Enrollment ID: I20150814013018
Medical Identifiers
Medical identifiers for Matthew Nicholas Kunkelman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629473012 | NPI | - | NPPES |
| PC4116 | Medicaid | SC | |
| 423828 | Other | SC | MEDICARE RHC |
| RHC151 | Medicaid | SC | |
| 428926 | Other | SC | MEDICARE RHC |
| RHC012 | Medicaid | SC | |
| 4173 | Other | SC | MEDICARE PTAN |
| RHC020 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 2209 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Matthew Nicholas Kunkelman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Matthew Nicholas Kunkelman, PA
Po Box 1245,
Orangeburg, SC 29116-1245
Ph: (803) 395-4497 | Matthew Nicholas Kunkelman, PA
187 Bunch Ford Rd,
Holly Hill, SC 29059-8224
Ph: (803) 496-3312 |
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